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conjunctivitis%20-%20viral%20(pediatric)

CONJUNCTIVITIS - VIRAL (PEDIATRIC)

Viral conjunctivitis is the inflammation of the conjunctiva that may be caused by adenovirus, herpses simplex or Molluscum contagiosum.
Infection may cause unilateral or bilateral eye redness, foreign body sensation and follicular conjunctival reaction.

Conjunctivitis%20-%20viral%20(pediatric) Diagnosis

Diagnosis

Etiologic Diagnosis
Diagnosis	Epidemiology & Predisposing Factors	Natural History of Disease	Signs & Symptoms
Adenovirus	Relatively common & highly contagious. May occur in epidemics. Usually transmitted through direct physical contact with infected person or object.	Self-limited with improvement within 5-14 days	Abrupt onset bilateral conjunctival injection (one eye may precede the other by a few days) with follicular reaction especially of the inferior tarsal conjunctiva, watery discharge, preauricular lymphadenopathy. Occasionally present: petechial or subconjunctival hemorrhage, pseudomembrane or true membrane. Superficial multifocal punctate keratitis may occur followed by subepithelial opacities. Filamentary keratitis may occur in patients who maintain their lids closed to minimize ocular discomfort.
Herpes simplex	Primary infection from infected individual	Usually subsides in 4-7 days without treatment unless there are complications	Usually unilateral. Conjunctival injection with follicular reaction, watery discharge. Primary infection: Follicular conjunctivitis & lid vesicles (blepharodermatitis). May have pseudomembrane, dendritic keratitis, preauricular lymphadenopathy.
Molluscum contagiosum	Predominantly older children. Can also occur in immunocompromised patients.	Conjunctivitis is associated with eyelid lesions which can spontaneously disappear or may last months to years	Typically unilateral but can be bilateral. Single or multiple shiny, dome shaped umbilicated lesions on the eyelid or lid margin. Mild to severe follicular reaction, punctate epithelial keratitis. May have corneal pannus in long-standing disease.

Laboratory Tests

Viral cultures & immunodiagnostic tests are not routinely used to establish diagnosis
Nucleic acid amplification tests including polymerase chain reaction (PCR) may be available for certain viruses, but they are not validated for ocular specimens

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Spotlight on multidrug-resistant gram-negative infections: New developments for an old problem

Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021

Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.